Prediabetes is Associated with Worse Long-Term Outcomes in Young Patients with Acute Coronary Syndrome

Rongdi Xu; Cheng Wang; Jiachun Lang; Jikun Wu; Yuecheng Hu; Tong Wang; Jingxia Zhang; Hongliang Cong; Le Wang

doi:10.2147/DMSO.S433112

Prediabetes is Associated with Worse Long-Term Outcomes in Young Patients with Acute Coronary Syndrome

Diabetes Metab Syndr Obes. 2023 Oct 17:16:3213-3222. doi: 10.2147/DMSO.S433112. eCollection 2023.

Authors

Rongdi Xu^{1

2}, Cheng Wang^{1

2}, Jiachun Lang^{1

2}, Jikun Wu^{1

2}, Yuecheng Hu², Tong Wang^{1

2}, Jingxia Zhang², Hongliang Cong^{1

2

3}, Le Wang^{2

3}

Affiliations

¹ Clinical School of Thoracic, Tianjin Medical University, Tianjin, People's Republic of China.
² Department of Cardiology, Tianjin Chest Hospital, Tianjin, People's Republic of China.
³ Tianjin Key Laboratory of Cardiovascular Emergency and Critical Care, Tianjin Municipal Science and Technology Bureau, Tianjin Chest Hospital, Tianjin, People's Republic of China.

Abstract

Purpose: The incidence of prediabetes mellitus (pre-DM) is increasing among young individuals. Whether pre-DM can predict adverse cardiovascular events in acute coronary syndrome (ACS) patients remains controversial. This study aimed to investigate the impact of pre-DM on the long-term clinical outcomes of patients aged≤ 45 years with new-onset ACS.

Patients and methods: A total of 1113 patients with new-onset ACS (aged≤ 45 years) who underwent percutaneous coronary intervention (PCI) were enrolled in this study. Patients were divided into three groups according to their glycemic status or history: normal glucose metabolism (NGM), prediabetes (pre-DM), and diabetes mellitus (DM). The primary endpoint was defined as a composite of major adverse cardiovascular events (MACE) including all-cause death, myocardial infarction (MI), stroke, or unplanned repeat revascularization. Multivariate Cox regression analysis was performed to explore the association between abnormal glycemic status and MACE.

Results: The prevalence of NGM, pre-DM, and DM were 45.9% (n=511), 27.0% (n=301), and 27.0% (n=301), respectively. During a median follow-up of 65 months, MACE occurred in 23.5% (n=120) of NGM, 29.2% (n=88) of pre-DM, and 34.6% (n=104) of DM (P=0.003). After multivariate adjustment, both pre-DM and DM significantly increased the risk of MACE compared with the NGM group (pre-DM: HR1.38, CI95% 1.05-1.83, P=0.023; DM: HR1.65, CI95% 1.27-2.16, P<0.001). Moreover, pre-DM had a similar impact on MACE as DM in young patients with ACS (P=0.162).

Conclusion: Pre-DM was common among patients aged≤ 45 years with new-onset ACS. Pre-DM was associated with an increased risk of future MACE compared to NGM.

Keywords: acute coronary syndrome; prediabetes; young patients.

Grants and funding

This study was funded by the Project of Science and Technology of Tianjin Health Commission in 2022 (No. TJWJ2022MS035).